Burden of stillbirths highest in Nigeria, 9 others – WHO

The burden of stillbirth delivery in Nigeria and nine other countries are among the highest in the world. According to the first ever comprehensive set of stillbirths estimates initiated by the World Health Organisation, globally, every day more than 7,300 babies are stillborn.

The report, published within a special series in The Lancet, shows that about 2.6 million third trimester stillbirths occur in the worldwide annually with Africa the worst hit.

Although, the stillbirth rate varies sharply by country, from the lowest rates of 2 per 1 000 births in Finland and Singapore and 2.2 per 1000 births in Denmark and Norway, to highs of 47 in Pakistan and 42 in Nigeria, 36 in Bangladesh, and 34 in Djibouti and Senegal.

“It is estimated that 66 per cent (1.8 million stillbirths) occur in just 10 countries. Nigeria, India, Pakistan, China, Bangladesh, Democratic Republic of the Congo, Ethiopia, Indonesia, Afghanistan and the United Republic of Tanzania.”

According to a perinatal epidemiologist and Chair of the International Stillbirth Alliance, and author of the paper on stillbirths in high-income countries for The Lancet’s Stillbirths Series, Vicki Flenady, “An African woman has a 24 times higher chance of having a stillbirth at the time of delivery than a woman in a high-income country,”

The new estimates show that number of stillbirths worldwide has declined by only 1.1 per cent per year, from three million in 1995 to 2.6 million in 2009.

Two-thirds of the stillbirths happen in rural areas, where skilled birth attendants, in particular midwives and physicians, are not always available for essential care during childbirth and for obstetric emergencies, including caesarean sections.

Almost half of all stillbirths, 1.2 million, happen when the woman is in labour. These deaths are directly related to lack of skilled care.

WHO’s Assistant Director-General for Family and Community Health, Dr. Flavia Bustreo ,said 1.1 million stillbirths could be averted with universal coverage of comprehensive emergency obstetric care, syphilis detection and treatment, detection and management of foetal growth restriction detection and management of pregnancy-induced hypertension.

Identification and induction for mothers with 41 weeks gestation, malaria prevention, including bednets and drugs, folic acid fortification before conception and detection and management of diabetes in pregnancy and strengthening of family planning services are also desirable.